A nephrectomy procedure is performed during general anesthesia. You'll receive a medication (anesthetic) before surgery so that you won't be awake or feel pain during surgery. You'll also have a urinary catheter — a small tube that drains urine from your bladder — placed before surgery. During the procedure, the urologic surgeon and anesthesia team work together to minimize pain after surgery.
During the procedure
The nephrectomy procedure varies, depending on how the surgery is performed and how much of the kidney is removed. Variations include:
- Laparoscopic surgery. In this minimally invasive procedure, the surgeon makes a few small incisions in your abdomen to insert wandlike devices equipped with video cameras and small surgical tools. The surgeon must make a slightly larger opening if your entire kidney needs to be removed.
- Robot-assisted laparoscopic surgery. In a variation of laparoscopic surgery, the surgeon uses a robotic system to perform the procedure. Robotic tools require very small incisions, provide better 3-D images during the procedure, and can make fine or complex motions that are similar to what a surgeon's hand can do in open surgery.
- Open surgery. In an open nephrectomy, the urologic surgeon makes a cut (incision) along your side or on your abdomen. This open approach allows surgeons to perform some surgeries that still can't be performed safely with less invasive approaches,
- Radical nephrectomy. In a radical nephrectomy, the surgeon removes the whole kidney, the fatty tissues surrounding the kidney and a portion of the tube connecting the kidney to the bladder (ureter). The surgeon may remove the adrenal gland that sits atop the kidney if a tumor is close to or involves the adrenal gland. In some cases lymph nodes or other tissues are removed as well.
- Partial nephrectomy. In a partial nephrectomy — also called kidney-sparing (nephron-sparing) surgery — the surgeon removes a cancerous tumor or diseased tissue and leaves in as much healthy kidney tissue as possible.
Your urologic surgeon will discuss the advantages and disadvantages of robotic or other types of minimally invasive surgery versus open surgery, including issues such as scarring and the time it takes to return to normal activities.
After the procedure
Recovery time after the procedure and the length of your hospital stay depend on your overall health and the type of nephrectomy performed. The urinary catheter remains in place for a short time during your recovery.
Expect to receive instructions before leaving the hospital about restrictions to your diet and activities. You may be encouraged to begin light, everyday activities as soon as you feel able, but you'll need to avoid strenuous activity or heavy lifting for several weeks.
For most patients, these procedures don't affect quality of life — once you're completely recovered, you can expect to resume your normal routine and activities.